The draft rules for the LTA have been released! As a reminder, the LTA rules are part of a larger package of rules, so we have created a separate document with just the pages containing the LTA rules. We are still analyzing them, so more details are forthcoming, but we are very pleased with the initial draft. Highlights are in the bullet points below.
On Thursday, July 6th at 8:00pm eastern, we will be hosting a webinar to review the contents of the draft rules (register here). On Thursday July 13th at 8:00pm eastern, we will be hosting a webinar to provide talking points and guidance on submitting your comments (register here). Recordings will be available a few days after each webinar.
The Public Comment Period will be open until August 29th. As soon as our submission form is set up (which will not be until after the second webinar on July 13th) we will send you the link to begin submitting your comments.
As a reminder, the Center for Medicare and Medicaid Services (CMS) will only allow one submission per person. If you submit a comment by other means or through another organization, a subsequent comment submitted through our form will be rejected. This is a CMS rule outside of our control, so we encourage you to review all of the webinars and written materials we will be providing before submitting your comment.
Highlights from the draft rules are as follows:
- Covered supplies will include standard and custom fitted gradient compression garments; gradient compression wraps with adjustable straps; compression bandaging systems; and other items determined to be lymphedema compression treatment items.
- Additional covered items will include accessories such as zippers in garments, liners worn under garments or wraps with adjustable straps, and padding or fillers that are necessary for the effective use of a gradient compression garment or wrap with adjustable straps.
- Two daytime garments per affected body part will be covered every 6 months, or sooner if the item is lost, stolen, irreparably damaged, or if needed based on a change in the beneficiary’s medical or physical condition.
- One nighttime garment per affected body part will be covered every year, or sooner if the item is lost, stolen, irreparably damaged, or if needed based on a change in the beneficiary’s medical or physical condition.
- New/additional codes will be created to facilitate reimbursement, including codes specific to non-limb areas of the body (head, neck, genitals, torso, etc.) to ensure that supplies needed to treat these areas of the body are included in coverage.
- CMS is seeking comments on specific issues where further clarification of the rules is needed, and we will outline those areas during the webinars and in our subsequent communications and materials.
Please register for our upcoming webinars using the links above if you are available. Thank you for your advocacy!
Heather Ferguson
Founder & Executive Director
Lymphedema Advocacy Group
LymphedemaTreatmentAct.org
